Ear pain is a common symptom in all children. As there are many possible causes of ear pain, any child that complains that their ear hurts should be seen by their doctor to differentiate the cause of the pain and appropriate course of action. Ear infections cannot be diagnosed appropriately over the phone and, as a result, supportive care should be administered until the child can be seen by a doctor. The following is a list of possible causes of ear pain and helpful remedies that may get you through the night until you see your doctor.

Inner Ear Infection

Cause:
• Bacterial or viral
• Stagnant fluid in the middle ear is a set-up for bacterial growth
• Fluid is common in the middle ear when a child has a cold or nasal congestion
• Not caused by water getting in the ear from bathing or swimming (see outer ear infection)

Symptoms:
• Nasal congestion
• Fever
• Ear pain
• Consider this diagnosis when a child has had a cold for several days then develops fever and ear pain

Treatment:
• Watchful waiting- current recommendations recommend waiting 48 hours to see if the infection will resolve on its own in certain situations
• Pain reliever/anti-inflammatory – Motrin/Advil –  as needed for pain
• Oral Antibiotics
• Numbing ear drops, many homeopathic remedies are available over the counter

Outer Ear Infection (Swimmer’s Ear)

Cause:
• Water sits in the outer ear canal and, as it dries, irritates the skin in the canal and causes it to thin. This allows for bacterial penetration and a painful infection.

Symptoms:
• Ear pain, especially when pulling on the ear
• May have discharge from ear
• No other symptoms such as congestion or fever

Treatment:
• Antibiotic ear drops

Prevention:
• Thorough drying of ears after bathing or swimming
• Over the counter ear drops such as Swimmer’s Ear

Nasal Congestion

Cause:
• Ears and nose are connected by the Eustachian tube
• When your child has a stuffy nose the Eustachian tube clogs and they may feel pressure in their ears

Symptoms:
• Nasal congestion
• Pulling ears
• May have fever (from viral infection, not ear infection)

Treatment:
• Over the counter decongestants if over 4 years of age

Teething

Cause:
As a tooth erupts through the gum line it causes swelling of the gum. Any teeth, but especially the molars can cause referred pain (pain that feels like it is in the ears but is actually in the mouth)

Symptoms:
• Drooling
• Putting hands in the mouth or gnawing on toys
• Low grade fever (not above 101 degrees F)
• Pulling or rubbing ears

Treatment:
• Massaging gums with your finger or a cool wash cloth
• Teething toys

• Pain relievers (see age appropriate dosing sheet)
• Topical gels/ointments such as Baby Oragel
• Homeopathic Remedies such as Hylands Teething Tabs